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tv   Key Capitol Hill Hearings  CSPAN  October 28, 2014 2:30am-4:31am EDT

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on the panel, to you feel something is lost when editorial is taken out of a situation like that in this sense that it does not acknowledge what you do as a writer, which is also pick up your own color and different pieces of the scene in that that is part of the editorial role as well? >> the person we cover the most is the person we know the least. we have all covered centers and mayors and governors. those people you see so much. you have a sense of who they are. they are guarded, like any other politician. you have a sense of who these people are in the way you have not a clue what this president is liked. i guess the question all the time. >> you feel like you knew what clinton and bush were like? >> i feel like a i have known each successively less
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i would not say that they were nasty. they tell you how much bush 41 was more engaged, dropping by the briefing room from time to time or seeing them in a casual kind of setting. and carter would do all of these things. and that was not the case with clinton, but the very first airforce one trip i took with clinton, he came to the back and was telling these southern eight stories in a funny voice, imitating royal folks. and you can't imagine that today. obama does come back, but even then it is very, -- some lecturing. so i think that what we miss, though, to give him credit, he does more interviews than his predecessors, has less to predecessors. [inaudible conversations] [laughter] >> i am not getting these interviews. i am saying, give him credit
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for at least doing this. what he is not doing in the bread and butter of what the correspondence do is where you take a day in and the. [roll call] are two questions, how about this, that is where you hear the president day and day out about the main issues. we go weeks without hearing his voice and being able to ask any question. an entire issues come and go, especially these days, without ever having gotten his perspective on what he thinks about this or that, what he thinks should happen, anything. it is so different from the last two. >> stephen, how does that impact how you cover the white house? >> i agree. also the question, even more so -- i think it is more important than the big news conference. >> i feel like of the four of us up here you wouldn't more likely. we have a much smaller rotation. i just think that collectively we have lost. >> and the reason i stopped doing it is because the president kept setting
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deadlines for the end of settlements. they don't want him to make that news. you know, that is a real problem. there is also a difference in atmosphere between those, just stand erect -- standing around and fire off a quick question. often that is more useful. if you have a formal news conference and see him once every two months, everyone stands up and asks these 7- part questions which allows him to pick a pc wants to answer in and just kind of ramble on. we have to be a little bit more, perhaps, disciplined. if it was this week, right, it would be, what do you think about a bowl of? by the way, the islamic state campaign is a disaster next week you have a mid term. basically -- i can't imagine that. >> everything kind of boils down to a question of, things are terrible. your presidency is going down the tubes. so he will just talk for 20
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minutes. you are better off saying, okay, is the operation of failure? then he has to answer it, you know? but the thing i think is the most important. my worry would be if we said, we need to see the president every day they would give us an endless line of pointless -- [inaudible conversations] >> the questions at least. [inaudible conversations] >> get -- the other thing i would say is the president spends a lot of time focusing on whether we get a chance to talk to him, the secrecy, the background, the supersecret background, these guys have been inundated. >> explain that. >> it has increased. >> explain that. it is bizarre. >> a briefing with 40 reporters. we are talking deep, dirty secrets. this is a bunch of guys giving spin that you cannot."
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tell me why this makes sense. >> we are allowed to use the information but not directly." [laughter] >> and then morning tv would say exactly that type of thing. >> exactly. yes. >> so step of these briefings on the record or put them in a traditional background kind of setting? >> i'm sorry, but i would say that that should be on the record unless there's a reason not to be. i got an e-mail to days ago, ebola, the president has been briefed. we have nothing else for you why? that is secret. we should make sure we do not have a name attached to that. the mentality honestly is we collectively have gotten this idea that the background is the default, not the other way around. by the way, we are guilty of this, too. we as a profession ought to be pushing these people more
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and more. we, by the way, i am stunned okay. can we talk? why would you ask that? why wouldn't you assume we would be on the record. you should assume we are on the record unless there is a reason otherwise. >> it suggests that the official is not convinced the information is true. our remember coming to the hill. it was getting worse and worse and worse. you know, his spokesperson at the time, there would be different -- if he felt good about the information, you can call me by name. a little bit less, i could tell. and then when it got really bad he would say, just say ally. [laughter] and then finally allies to get the impression he had more than one. [laughter] >> so what do you guys think
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about another thing on our list, the embargo information in the way the administration uses it? and of the new york times as a follow on war going on with the white house in terms of this embargo information, but the bush administration used to put something out in the evening that is under an embargo that is really lame -- >> it is not news. >> it is not news. it is just trying to manipulate a new cycle. [inaudible conversations] [laughter] >> i mean, would that be something that would be on your list of things that you would -- >> i think so because if it ever turns out to be something real and substantive we are handcuffing ourselves in terms of reporting on something that might actually be out there. they tell people around town, we ought to be aggressively reporting it, if it is something real.
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most of the time it is nonsense. i think embargo's at least in the old days used to be for a budget, something genuinely meaningful. the 9:00 deadline, all of that makes sense. this idea that i am going to put out there is a report about how our job-training program evaluation might be finished two months from now, i don't need that. so we had a couple of occasions where they put something out and we found out from other sources what they were going to say. i'm sorry, we're not going to stop reporting. they get mad at us and take us off the list the next time. fine. but this invites that kind of conflict where they are mad because they think we busted embargo. it should only be for cases that make sense. >> steven, you have recently
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been out of white house coverage. is there anything that, since you have left but have noticed or that is different about going from being a wire rack sitting in the press -- [laughter] >> right. so maybe how little you miss it. [laughter] >> you are in the honeymoon phase. >> a really good joke. i mean, there are lots of things you miss breed you are watching history unfold and everything else, but you certainly do not ms. e-mailing people at midnight hoping to get an e-mail back. right. right. like the kind of -- and it is kind of nice to go outside the white house and people actually return your calls when you phone them up. you know, i am talking to king -- campaign people now.
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these are the people that at the beginning when they still had their careers before them, hope they have latched onto a guy that would be present and it is some massive -- [inaudible conversations] >> no comment. [laughter] ..
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it was an off the record sessi session. what is your take on those and you said off the record basis is a good thing but i just wanted to hear your position on these times when he brings and journalists off the record and the whole thing stays off reco record. >> i regularly came to talk on the day he was going to announce that his campaign he invited a couple of days working in various administrations i would call all the people who had been in meetings to get a sense of what he was saying and try to get a sense about what's on his mind. the off the record restrictions
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do not apply to me so i wasn't there. i can't be held to a ground rule that i didn't agree to our profit from and you know it's our job to find out what he's thinking and members of congress have gone in and talk to him about this i would have called them and hopefully they would have told me what he said as well. i mean i agree with margaret that records are some ways useful. you can't have 15 or 17 and at a time and expect that that's going to be an off the record thing. that's not -- background briefings of 40 people off the record with 15 to 17 but these are public events in effect and you know that's not the same thing as i'm going to bring in two or three for 15 minutes. i also think it uses a substitute on the record which they shouldn't be. >> i want to clarify. i'm not saying on the record that we shouldn't be a list types are present on the record. that's always my preference but
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all i'm saying is that we have such little access to him as the people who cover him day-to-day anyhow that when we do have the opportunity to talk one r. on one -- one-on-one or in a small group of him which tends to be off the record i think it's a valuable experience not just for their porters but kind of for him. he gets a vibe about what reporters are interested in talking about and we get a vibe about what he's feeling because we have proximity to him and they are the signals that are conveyed through per se. they can be conveyed through a person but if i gave the impression that i favor that over the record that's not all what i'm saying. all i'm saying is i don't think is risky for him to talk to us as the team has convinced himself that it is. >> he's not saying off the record he doesn't want to be part of the conversation. he just wants to be on his terms so if you have a columnist and he's hoping to influence the
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columnist. he wants them to understand how he's he's thinking in the right stories and columns that reflect that. so be it. it's not off the record like i'm going to talk about my daughters and i don't want anyone to know about this. this is his attempt to influence and shape the discussion in washington. that's something we should report on. >> can you use the mic mic and that way we can hear you? [inaudible] >> i think there are different interpretations and i think if you are involved in those you should clarify in the beginning how that's intended because we have had that happen where i think one of my colleagues saw people going in for an off the record report and eight got reamed out by the white house and so forth. it's a great idea that was off the record. i'm against off the record in general. i just think it's a president of the united states. what he does is not off the record especially talking about
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war and peace. he's talking about things of great interest in great importance to the public. it's our job to figure out what he's doing, what he's saying and who he's doing it with and you know. >> does anyone else have a question? can we go to alexis and then we will come to you. [inaudible] [inaudible]
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[laughter] >> first of all it is intimidating when you walk into that meeting and you report something and then they come down on you and oh my god. i have had senior officials go to my bureau chief as if that was going to make a difference. but you know it's tough and i think the advice is first of all you can't be intimidated. you've got to charge forward but you also need to be a responsible reporter and you need to also be trusted by tho those, by your sources. you need to deal with your sources in a responsible way and
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you need to be able to be trusted by them to deal with the information in a responsible way and understand the difference between what's on the record and off the record a basic stuff like that but also to be fair. when you are going to write a tough story, and i have not always lived up to this but one of the basic basic things this dull surprise people. if you are going to nail somebody with a story, you know give them a chance to respond before you have gone out with it and don't surprise them with it. let them know it's coming. that's a big part of it. sometimes there won't be any response but let them know they are about to get hit with something. so i think if you deal with those officials and may you know, a reasonable way and a trustworthy way it's a lot easier to ignore it.
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it's going to pass, you know, it's going to pass. you think oh my god they are never going to talk to me again. they will talk to you again because they are interested in talking to you. >> i have nothing but respect. [inaudible] [laughter] >> you know i think my main and josh has brought it up more you could get a mix of people asking questions. we have gotten into this habit of you know going down the line and people will ask multiple questions on multiple topics. i mean i have been at other white house briefings where
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there was a different style. the first subject is ebola and everyone will go around and scream out their bolo question and then we will get to then send them you get people following up on other's questions. i think it's the most important thing in a follow-up. not only you following up but peter asks something in me being able to jump in and follow up. so i would like to see white house briefings done more like this panel, you know? >> sometimes we hurt ourselves with budget cuts and not doing it ourselves and cutting back. going back to that whole argument about being able to
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interact with audiences and people. i can recall i remember clearly being with sam downs in a snowstorm watching cars -- and there was no question that was a producer or anyone else but we had to be there. sit at nbc said we have a 7-year-old president and this -- we will be outside. that's the premise that you had to be there ready to go at any moment. i think we ourselves have gotten budget cuts but it's easy to say when we are facing these.
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we really need to be at every speech m. if something changes. >> he has talked a lot about bosnia and let us know what he's thinking about bosnia and obama is a little bit more disciplined than that but i agree with you. >> networks don't go onto domestic trips regularly. a producer will go or what i mean it's wrong. >> i do think that a lot of this conversation today is going to be holding the white house's feet to the fire in terms of how much access they are voluntarily giving out but we can all do a lot of inward looking about our rebranding of the white house better and does not completely undercut our premise for them not doing that?
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are we completely undercutting our premise for why we can't be there? we have to hold ourselves to the high standard. >> i just have one question for the panel and i'm going to go very granular. peter and john were getting at an important thing that we need to resolve as a group. i want to ask you a simple question. if you knew that you would see the president in the briefing room once a week taking questions would you agree that the photo journalist could go in without editorial presence? barring whatever you want to add in there but let's just say this is really a thing. the white house has offered us more visuals on the president which means a lot to tv cameras in the photographers. but those of us in print pushed back because we want the editorial presence every time and we want to increase the number of times. we can to ask spontaneous
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unscripted questions in a real reporting situation. so setting aside, agreeing and simulating that we agree that the editorial should be in there and the full posted whenever everything if you knew you would see the president once a week taking questions in the briefing room would you have a different view or would you relax the idea that uis need the editorial presence? >> the news you want to get the president's comment on might be on a tuesday. it would be great to have it there on a friday but unless he agrees to come and we want him to come. but i don't see that happening. >> remember that the pool is going to be a spray. we can yell and scream loudly but sometimes that means we get a question, we get a setting where there's a question but a lot of times it doesn't mean
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that and we still don't get the weekly chance to grill the president in the briefing room. >> the last time the president gave a weekly press conference was like eisenhower kennedy so if you were actually to come and do a real news briefing, not just one question or two but waited until the summer when he didn't have a strategy. [laughter] that would be a trade-off for thinking about. that would be an extraordinary commitment. i'm not convinced they would make it that i think we could ask the questions once a week would be pretty -. >> i think this principle of an editorial is very important and i mean i feel strongly about that but if you did have were you could ask multiple questions every week it makes a little easier to consider something like that. maybe off the record but if you
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have access, i've always thought a bedrock principle is if that you have on the record access for off the record stuff is fine and very helpful. this is a variation of that but i agree. i can't imagine they would agree to a weekly press conference. i think they might make that promise and we will see if it actually happens. >> you never know. >> we will wait for re-election. >> president for life. [laughter] >> margaret did you have anything? >> i think like the panel said i think if i think about i think if i were to actually happen it would alleviate a lot of the pressure for someone to be there with a pencil and notebook staring out the window and it's useful for photographers. it can be an absolute promise like we will never ask for
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access during the week because something like yesterday with the nurse, the ebola nurse is ridiculous and of course there should have been full poll. it's just silly and it doesn't make any sense. if that's off the table because we cut some deal about friday availability i think we have traded something really precious away. not that we have it now but. >> we don't have it now. we don't have a right to complain about it. >> what has been happening is it's not good for democracy and life as we know it, it's not. [applause] >> this was fantastic. thank you so much. let me say a couple awards. first of all i want to say thank you to this fabulous pool. [applause] that was tremendously helpful and thank you for giving up all your trade secrets. i want to take a moment to thank
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than national association of broadcasters which is the host of this event today or has given us the space which is beautiful and when you go and see what their bar looks like you are going to like it even more. abc and cbs were supportive as was our member who felt really strongly about the symposium and wanted to give her personal support so she made a financial contribution. [applause] and so now after talking about the practice of journalism we are going to go celebrate great journalism. please join us in the bar and that's where we will have our choubey it were wonderful esteemed inspiring colleagues. [applause] >> thanks guys. [inaudible conversations]
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[inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations] [inaudible conversations]
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[applause] >> i would like to add my welcome to everyone. this is a big issue, the topic of ebola. it is a major international and domestic public health quandary. there are lots of opinions flying around, lots of gut feelings and i believe lots of fear. there is very visceral reactions to this problem. people recognize it as a horrendous disease with a high mortality rate, really scary symptoms and probably the
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scariest thing about this time right now is a week away from an election. i'm not saying that totally tongue-in-cheek. that does affect people's opinions on things. what i'm hoping this morning will to will inject some reason, some facts, some calm. [laughter] she works for me. i was not a set up. we wanted to bring together a panel that could really hopefully give some logic and reason to this whole thing. i've i mentioned to the panel before we came in this panel has more degrees than any panel i have moderated in my three years at heritage and it hopefully will meet the needs of the group here. before you introduce them i will say this. we are going to give each panelist 10 minutes to speak on
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various aspects of the issue said here and then we are going to try to give as much time as possible for q&a. i really and i say this every time i moderate but we don't have time for floor speeches so when it gets to the q&a please ask a question, identify yourself and answer the questions is singly so we can get the answers from a panel that everybody in the audience wants to hear. if you really want to give a speech sometime see me afterwards. we will talk about it and get it arranged but not this morning. introducing the panel. we have first dr. bob kadlec the managing director of -- he had senior positions in the white house, the senate, the department of defense and was a special assistant to the president's senior director from biodefense policy on homeland security council. he has degrees from the air
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force academy. he has a doctorate in medicine and a masters in tropical medicine and hygiene in the uniformed services university of the health sciences and a master's degree in national security studies from georgetown. next ms charlotte florence. charlotte is the policy expert at heritage for africa and the middle east. dealing with economic freedom, democratic institutions development and security cooperation. she was also an expert on international security and foreign-policy issues for the senate homeland security and government affairs committee and for then senator scott brown. she has lived and worked in africa before and she holds a bachelor's degree from the university of southern california and a masters in the war studies department at kings college in london. next to her is dr. tevi troy the
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present of the american health policy institute. he was the deputy secretary of the united states department of health and human services. he and his actions there included implementing issues combating bioterrorism and public health emergency preparedness. he was also the acting assistant to the president for domestic policy during which time he ran the domestic policy council. he is presently writing a book about presidents and disasters and how they respond to them. he has a bachelors of science and industry and labor relations from cornel and an emmy and ph.d. in american civilization from the university of texas at austin and our fourth panelist is dr. tara zubaydah mission manager and senior fellow at in detail. dr. o'toole was undersecretary
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for science and technology at the department of homeland security. she served from november 2009 to september 2013. she before that was the ceo and director of the center for biosecurity at the university of pittsburgh medical center and a professor of medicine and public health at the university of pittsburgh. she also was a major designer and after into major biorelated exercises and before that one known as dark winter in the other known as atlantic storm. she has a medical degree from george washington university and a masters in public health from johns hopkins university. i will just throw out while i am not giving any remarks on the panel if there are questions about the specific military aspects of the mission going on in africa i will be happy to try to field those as well because
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as special forces officer we worked in africa and we did a lot of humanitarian operations in the past. with that i will pass it to dr. kadlec. >> thank you for giving me the opportunity to be with you here today. the best way to phrase my comments about the ebola crisis is to reflect on the great philosopher by the name of yogi berra. this is déjà vu all over again. i think one of the things we need to understand is that this issue is ebola is not something that has been first encountered today. we have gone through a series of infectious defense in the last decade or two that i think has highlighted the importance of and the necessity for the kind of preparedness which is not something we have put in
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national security day including the events of ebola crisis regardless of data political impact and is really reflected the fact that this going to change a part of africa and maybe the world in our ability to mitigate the outbreak as it stands. that may be more concrete on that. back in 1992 and i dare say many people may not recall this. the institute of medicine drafted a study on two notable virologist. one was joshua lederberg who was a nobel laureate and the other one was robert shoup who is a overall it adjust from young university. what they outlined in a monograph which you can still get today on line or in a library was really the impact of emerging diseases around the world. it recognizes that there's a
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change in human behavior the change in environment, the changes every aspect of our lives including the mania revolution we have impacting our ability and our perception that not only emerging diseases but what impact it would have on our society. it's worth knowing even then they identified the need for some kind of collaborative manner to manage these outbreaks because in all likelihood they would have greater uncertainty in the future. again the certainty they had was man will be faced with these nonaggressive diseases. they identified the role of urbanization as we see here that was a critical link to the current ebola outbreak as it relates to the likelihood that this would be something more than a flash in the pan that it had been before. historically ebola has occurred in remote villages where people were limited by their ability to walk any distance or have access
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to health care capabilities so many of these people who were infected pierced and villages and the results of those outcomes were containment. you recall back the spring of this past year ebola found its root in the urban environment and that change the complexity of the outbreak in the world of transmission in that setting. certainly where they had herr health care facilities primitive by her standards became a focal point of the disease as well as cultural practices. it just highlights the fact that in some ways the world has changed and we have changed and they really need to keep up with that. one of the areas i was asked to focus in on was domestic so let me spend a moment to talk about that in the next five minutes or so. my background was in detail by steve both steve and i have i guess a familiar background in that we both spent time to
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special operations. i did so as a medical officer and i will give you a quick anecdote of what i learned my 20 some odd years of being a medical officer supporting operations. i interviewed special operations right after the tragic events of desert one when we failed miserably in terms of rescuing hostages out of iran. it was recognized by the halloway commission that there were certain essential elements about the future of american special operations a contingency that we couldn't define today but we know we will encounter tomorrow. for very simple ideas. one was recruiting wellness training one was equipping and one was exercises. with that that became really the hallmark of what again american special operations forces over two decades focused on, putting
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the best people training them equipping them with state-of-the-art capabilities we had an exercising them under realistic conditions. people like general downing and stanley mcchrystal all embrace that concept and with it if you could look at it in this experience was the event in abbottabad where we basically ended the life of osama bin laden. it wasn't something that happened in one day or one week, when one year but literally decades. so i'm arguing today to you that there is no such thing as time preparedness. the commitment we make around public health awareness for ebola as we see it today and in the future outbreaks and the pandemic influence and maybe other things that are just as bad or maybe worse could occur and we are not even talking about terrorism here are things
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that we have to -- so let me give you some basic concepts about what we are committing committing to ram preparedness today. our health care industry is about $2.8 billion a year activity. the government invest $250 million in preparedness. we spend more money on potato chips in this country than we do on health care preparedness. that is one thing to keep in mind. we have spent between eight and $9 billion a year in national missile defense. overall if you look at our entire expenditure on medical preparedness that includes the drugs and vaccines that we would need as well as health care preparedness is somewhere between roughly $7 billion. so we are paying more to protect ourselves against the existential threat than is represented by a single nuclear-tipped missile that we are spending on the likelihood
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of a pandemic like the ebola crisis and even potentially some kind of deliberate act that could happen in the future by a terrorist or state actor. we have not quite conceived of how we need to think of this capability. one thing we need to understand is that there is no political divide over this. in my -- during my tenure in the senate there were certain stance that we were two opposites attracting each other and we were able to do extraordinary things. one was senator richard burr from north carolina a conservative moderate and the other with ted kennedy you could called the liberal liberal from massachusetts. but they were famous to these together and it wasn't by accident. in fact it was created by relationship that occurred between kennedy and former senator bill frist early during
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the clinton administration when the clinton administration realized that these issue with figure prominently in the future. some think not only the world we live in a globalization and human behavior but the likelihood that we are more likely to become significant in the highly connected world. it was the idea that they had that somehow we had to have the same institution than in the national security realm and the department of defense. a significant example which is the goldwater-nichols act of 1986 which reorganize the department of defense to give us what give us a way of today i have a capable joint fighting force with the model used to create the pandemic will hazard preparedness act. it may reflect in some ways my military background but it has reflected if you will a coherent means to effectively work across
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the interagency and the federal government the department of veterans affairs health and human services who have major medical assets as well as state and local activities that really are the front-line fighters. the point was to create someone in charge which was the secretary of her preparedness and response in the other thing was to create an entity or activity that would give us a chance to develop medical countermeasures we would need to fight outbreaks like a bowl with the therapeutics and diagnostics that were necessary. in that case it was circumstance where it was recognized that there was no commercial injury in a vaccine like this until something happened and it was way too late even if it takes 10 years on average to develop a medical therapeutic vaccine. it costs about a million dollars so you can imagine the reluctance of the pharmaceutical
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industry to basically embrace that caused without any certainty of a market. very things the federal government did that were extraordinarily important in the times right after 9/11. one was basically creating bioshields which was a guaranteed market for countermeasures in the amount of $5.6 billion over 10 years. the second was the creation of the -- which was how do we put somebody in charge of the overall federal effort to these kinds of defense in the third thing was how do we make the countermeasures we need. part of that was investing into nyad. tony fauci who is the poster child of that organization and articulate spokesperson on the ebola crisis and a true scientific expert in these areas but also the idea of how do we build not only what they take for research and development that's how do we make it into a product that we can stop our land use and that was the function of the advanced
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research development agency. i would argue that over period of time that these things have been developed we have a lot lost her eye and the above. between crises we have seen things that are being covered are funded and in reality those things have suffered significantly. it is a circumstance that we need to report. after this ebola crisis and senate will and that we need to prepare for the next crisis in ways that may be different from islam. we are fortunate that this is not an airborne transmitted organism. certainly it can evolve over time into something more bearlike but i don't think that's the estimate of the experts today. i think that's very reassuring. the second thing is as far as ebola does today it is limited in their geographic area that quite frankly makes it manageable if you can get ahead of the virus.
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a noted epidemiologist from university of minnesota talks about the virus and it was behind the virus. until we can catch up and use the resources we have that would effectively limit the spread of this disease around the continent and in the world i think we are better off. certainly from united states perspective we can demonstrate and we have so far that we can manage these sporadic cases very well. certainly there would be more challenging but right now we have a bit of time to train health care workers to recognize and effectively isolate and quarantine people who may have been exposed to the disease and who may have the disease. that is functionally something we need to do for the vaccines and therapeutics that we have in the pipeline if you will better
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being rushed if you will to be used to clinical trials that will be done in the united states and africa can buy time and hopefully save many thousands of lives by giving them are properly. peter i will turn it back to you. >> thank you for putting this panel together together. good afternoon. today if i could highlight some of the geopolitical considerations in west africa about ebola. ultimately operating in west africa the united states. as long as the outbreak continues to grow in west afri africa. everyone is at more risk. of the three countries facing widespread ebola josh transmission the ebola crisis is just layered upon already quite volatile and challenging
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developmental situations. liberians sierra will play on the endured years of civil war and their peacekeeping operation in guinea experienced a guinea experienced the q. guinea experienced a coup in 2003 while sierra leone was ranked highest among the three countries in imad abraham governance all three countries scores are below the comment average. guinea is ranked a dismal 42 of the 52 countries measured with library and not far behind. i'm looking at the u.n. development index based on life expectancy child mortality rates education and employment among others. library is ranked 175 with 187 countries measured. guinea 179 in sierra leone 183. years by governments ongoing conflict poor fiscal management have plagued these countries but despite relatively high growth rates and an increase of fdi in a post-conflict there in liberia and sierra leone significant governance challenges remain. this couple of urbanization and
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increased and travel to rural villages and cities across borders create an environment much different than previous ebola outbreaks that have been isolated to relatively remote areas in central africa. ebola spread across the region in a perfect storm local governments did not act quickly engaged national community did not heed these early alarms. as in the case in liberia this past august belaboring government took desperate and unhelpful measures when a quarantine to west point the largest neighbor to to monrovia at the capital of liberia. islam quarantines created more internal problems spread the disease further and wrote a little trust was left in the national government. more than 50,000 people lived in shacks and west point. it is the perfect environment for the disease to radically spread. there's also limited education about the disease and public health officials weren't able to get ahead some of the calls from behavior that speed up transmission rates of ebola
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particularly around bear of a country like many places in the world families grieving the loss of loved ones wanting to ensure they were given proper burials which at times included improp improper -- improperly removing the body from body bags into traditional body shrouds are washing the bodies themselves. the bodies are extremely contagious after the person is dead. the usm partnership with local governments ngos along with education campaigns are working to get ahead of some some of these they are on cultural challenges. one easier fix is by use white body bags are the caretakers are using. there have been some small -- presence on the ground. ebola responds is applied at west point is one of a few monrovia neighborhoods where residents have taken charge of the containment effort. some may argue that's because the government was not present for quite some time. still there are not enough
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influences are better hospitals to accommodate the increasing number of ebola victims and organizations such as doctors without borders are resorting to home care kits because they don't have enough beds or vehicles to get victims to emergency treatment units. of course this is better than nothing. still insufficient to medically treat infected individuals and ensure proper isolation. things are not moving fast enough to get ahead of the infection ratio. because of infrastructure challenges on the ground and the start of the rainy season usat let humanitarian operation has been slow to get off the ground. in addition to the heavy toll it has taken on the lives of individuals in the ebola affected countries were now starting to see the real ramifications of the outbreak upwards of 3700 children have been orphaned in this crisis. most health facilities and community health workers have been redirected to the ebola effort bending those with common diseases in the region such as malaria, tb hiv and pregnant women have fewer places to turn
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for cap is estimate nearly 800,000 women will give birth of the next year in all three countries combined in sierra leone 57,000 people are living with hiv nearly 3000 died last year from aids. schools have also been closed for months or there's a real possibility food shortages affecting these countries. markets have been closed and farmers aren't farming. people aren't able to work. as the world bank is highlighted blonde the immediate economic costs to contain the epidemic they are serious and direct economic consequences including higher fiscal deficit is rising crises lower household incomes and worsening poverty. growth estimates for guinea have been halved from 4.5% to 2.4%. the country has experienced an exodus of farmworkers critical to their key export products such as palm oil. for sierra leone a country that is often cited as one of the
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fastest growing economies in africa with an annual growth rate of over 11% their projected growth has dropped from 8% in 2014 and likely to be no growth in 2015. the country has experienced a substantial slowdown in critical mining operations. in the hardest hit country of all liberia or world bank revises 2014 growth projection from 5.92.5% and will likely experience negative growth in 2015. accelerating economic downturn the two largest companies have suspended operations as a result of the outbreak. begin to reiterate if we are going to protect the united states against ebola addressing the problem not the symptom will be critical to containing a bowl and long-term. governments need to commit to this effort because just as the u.s. faces this challenge the ebola outbreak is in their region in the neighbors yard. i want to outline that countries
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countries that have faced ebola outbreaks in the past have continued to help the ebola affected countries. united health care workers and training. enhance cooperation will be necessary among international partners. ebola affected countries regional community leaders in the private sector to address the crisis in the social consequences of this outbreak. the bottom line is the u.s. will be saved once the outbreak is contained in west africa. >> thank you charlotte. >> thanks very much for putting this out together and for moderating. i agree with just about everything that my co-panelists have said thus far. the only exception i would make is a minor one and in contrast to what steve said i do not believe the fact that we are having an election next week is the scariest thing about ebola.
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steve i hope you take that,, and a the humorous vein which was offered because i have a rule in life which is never to anger a member of the special forces. i is steve mentioned writing a book about disasters and i like to look at the situation in context of presidential leadership and the need for presidential leadership to address these kinds of situations. i would like to take a step back into history to the 1918 great influence or spanish influenza which i think is a misleading term but nonetheless what it is now my. influenza took place during a time of world war i and the charlotte was saying there was certainly the problem of correlation between a difficult situation and the spread of diseases and it's almost certain that the 1918 flu was exacerbated by the disaster of world war i by troop movements
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and the establishment of refugees and instability and in many cases by u.s. policy. 675,000 americans died in the 1918 flu epidemic and as many as 50 million worldwide. 675,000 which is a staggering number when you think about the number of u.s. soldiers who died in world war i it was 116,000. there was an overlap because some died of the flu. in any event the number of people who died of the flu in america died at a much greater number in that situation and in the process of working on my book on presidents and disasters i looked into what president wilson did about this disaster situation, the worst disease outbreak in u.s. history and really mortified to say what
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president wilson did was basically nothing as we have this disaster situation with hundreds of thousands of americans dying. there was one point in which his own personal doctor who was a navy physician said to him we have got this problem and it is being spread in part by u.s. troop transports not only spreading disease among other americans in a fairly confined conditions across the seas to fight the war but also it is spreading disease around the world as american troops are reporting to different places. in president wilson raised this issue in the white house with the person who is the equivalent of the army chief of staff of the time and the army general said we absolutely could not change troop transports in any way. we could not change our policy and we needed to send troops over in order to win the war and there was to be no change in policy at all and president wilson weakly assented and made
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no other point about it. it's particularly interesting and of course the general had a point and i try not to in addition to not anger and special forces not to contradict generals but when they had this conversation was one month from when the hostilities in europe were about to end so it's not as if this is a key point in the war. it's a key point in the process. another aspect of the wilson administration's approach to this was not necessarily directly related to the disease but it had negative repercussions which there is a strong propaganda effort by the u.s. general of that war to not only promote happy talk at home but also to really suppress dissent in the u.s.. the head of the office of public information had a much more direct approach than someone with usaid today.
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in that effort, pretty much the suppress talk about the flu was not to scare people about the flu and wilson was explicit about this, everything was about winning the war. there were more things that the u.s. could have done. in fact there's a sharp contrast between the cities of st. louis and philadelphia both of which were about the same size at the time and st. louis instituted social distancing. getting together for big parties and trying to not get together as movie theaters and philadelphia put together no such suggestions. the death rate in st. louis was five times less than in philadelphia. the truth of the matter is we didn't understand that much about how disease spread and we know a lot more today but the fact of the matter remains that you needed presidential and good
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government leadership to do deal with these situations. i take to heart the comments about the need for bipartisan cooperation. in the mid-1990s both speaker gingrich and president clinton who has everybody recalls were in the midst of some pretty nasty partisan fights between themselves both of them read the book the hot zone which deals with a weapon iced ebola and agreed there were things the u.s. government should do to be better prepared. in 2004 president bush read a book by john berry about the situation i talked about with the spanish flu and he was very moved by that book and the u.s. government did precious little about that situation and push the u.s. government to have a plan in place for flu which is something i worked on from the planning stages at the white house and when i was over at hhs and it included a number of
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stuff that bob talked about including the development of countermeasures and answering a few questions about how to deploy, how to distribute resources, who's in charge in various situations and included a number of types of scenario planning, exercises and what we found was that every time we have these kinds of exercises and i am sure tara can talk about these exercises and how useful they were the raise questions that you didn't have answers to to find out that there were holes in your system and things you need to think about for the next time. ..
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has been almost criminally on the job. and it is not just ebola. in 2009, the mexican government was very slow to pick up on what was going on in mexico. both of them were about three weeks behind what certain private sector companies were able to predict was an emerging problem. the truth of the matter is we have much better technology for detecting problematic disease outbreaks today than in the past, even something as simple as an internet search steal information about
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developing symptoms. it needs to be more refined and technologically studied. but it is an indication of the kind of tools that we have now that we did not have in the past. i think we need to be faster picking up on these issues. second, in terms of development, and this was talked about a little bit, we obviously have been way behind in terms of countermeasures for ebola, some kind of vaccine, some kind of cure. can that barrels that are dedicated to certain conditions. we need to accelerate efforts on that front, and have been accelerating efforts on that front, especially the vaccine. and in 2000 a promising trial was announced for dealing with ebola vaccines in monkeys. the crisis, no vaccines,
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approved and available situations. we need to improve our development of countermeasures to deal with these kinds of problems. in terms of deployment, there are all kinds of questions about the use of military, and i agree with obama's decision to send troops there, but there are questions about rules of engagement. and there have been a lot of questions about what exactly they will be doing. think there will be doing the right things in terms of building capacity and public health facilities in west africa, but it seems like some of the stuff is being figured out on the fly. there was a report by the inspector general at the department of homeland security that said the department of homeland security seems woefully ignorant of the countermeasures it has for times of crisis. we do not necessarily have all the answers in terms of what we have and could
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potentially send if needed, and in terms of directives, every time we see another ebola situation in the u.s. it raises questions about travel bans, questions about whether people should self quarantine or have imposed quarantine, cdc protocols command these things are being adjusted. for the most part cdc has done a good job in recognizing the differences between dealing with ebola in the first world health care settings, different dangers and different approaches. and we need to be cognizant of adapting our protocols. but as we learn from every exercise command seems like there are additional questions that need to be answered. it we are much better off today than we were even 10- 12 years ago in terms of dealing with a dangerous spiral of break, but there are many questions that need to be answered, and we have more work to do.
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>> okay. well, thank you for having me. many aspects of this ebola outbreak would have been filed here to people fighting in the peloponnesus and more, which was interrupted in important ways by some type of epidemic that we still cannot identify, may be played, maybe smallpox. but epidemics of infectious disease are something that have been events through human history, having mentioned the 1918 flu, we can also thank the black plague which killed a quarter of the population at the time, a circumstance which some historians attribute to the beginning or was instrumental in the beginning of capitalism, but epidemics are always with us
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we have had an unusual 100 years in the developing world in which epidemics have been much less present and much less terrifying than they were in previous history, in part because of better sanitation and nutrition in the developed world, in part because we have antibiotics and better science. in 1919 we did not know what the virus was. we literally did not know that viruses existed. so this explosion in medical and biological knowledge that we have had over the last century, in particular i would argue in the last 50 years, has been a game changer. but we are now in a time when we can expects to have a lot more epidemics that challenge us, and i will leave bio terrorism aside which i could go on for hours about.
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that would be another lecture. at least off the top of my head. we are adding 70 million people to the planet every year, living in megacities where most people have poor sanitation, nutrition, and are living right next to their animals. two-thirds of the emerging diseases that we have discovered in the last several decades have been so analyses that affect both animals and humans and jump from one to the other. we live in a world in which you can fly around the planet in 24 hours as opposed to this six weeks it took a steam shipped across the atlantic in 1918, and we have very, very interdependent in terms of
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supply chains, economies, the way that we live our lives. as you saw, mr. duncan, the gentleman who got sick in africa and died in texas came over to be with his family. that did not happen a whole lot, even a decade ago were two decades ago. so we are going to have a lot more epidemics. and we have a lot fewer effective antibiotics because of armies use of those miracle cures. and we have been trained in the u.s. government at least over the past couple of ticks exposed to get better at our response to these events. now what is similar about all epidemics, first of all, it is very hard to see the beginning. they start slowly. these are not lights and siren events, not like explosions.
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by the time you see them usually, even in the u.s. they are bigger than you would like them to be because what you want to do is see them soon and. >> them when they're little. all kinds of surveillance approaches have been tried for infectious disease, and none have worked very well for reasons we can discuss. we have to get better at that. one component that is really good is active diagnostics, not our current situation. we need something that works more like a band-aid that turns blue or a pregnancy test that individuals can apply and figure out if they need to isolate themselves force stop worrying. another aspect of epidemics is that they always, always engender a particular type of fear. it is a visceral fear.
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we can argue about why that is. it is one of the reasons that so many novels are about plagues. it is pretty freaky that you might end up bleeding from your eyeballs in the case of ebola, but also disease is something that comes into your home, so people immediately worry about their children in particular and their family. everyone feels vulnerable. after september 11th everyone in this area of the country was very focused on that event and feeling very shaky about it. in the west coast it was a very different situation. they felt very removed from being targets. not so with disease. everyone feels vulnerable. ethier drives a lot of the reaction amongst politicians as well as normal people all the time. this is not going to be over
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in a month. i think that is, perhaps, something that the governors who have imposed quarantines in the northeast overlooked. this is not going to go away in 60 days. they're looking at have quarantines travelers for your to. that me tell you, there will be cases coming out of the uk. are we going to forbid travel from london? this is going to get, you know -- this is going to go on for a while, even if we are very, very successful in containing it. epidemics always, always cause social disruption and exacerbate the scenes of society. you are always looking for someone to blame. when we had smallpox outbreaks under teddy roosevelt, the immigrants were blamed. that is actually a fairly common group to blame in any epidemic situation.
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but people have a hard time understanding predictability in disease and predicting why they might be say for how they might be kept safe for who they could lock up to make them safe. all of these things happen in every epidemic. part of what we have to do is understand this phenomenon and guard against our better judgment. so we will be more vulnerable to epidemics. we have got to get better at managing. for a variety of reasons we are much better able to manage them. bob talked about all of the different programs that were put in place starting in the late 90's. i would be less polite. i think that they mostly failed, particularly those aimed at generating.
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we have learned a lot from these programs. they have not been useless. we had our usual american predilection to find heavily when the crisis occurs, and then the money dribbles away and gets moved to other things. about a third of that money from terrorism got moved to a flu, not necessarily a bad thing, but it never came back. particularly when you are doing research and development, which is a lot of what the countermeasure efforts were, this budget pattern is very cost effective because you never figured out if what you invested in the front end was working and not. we were at an amazing moment in the history of science and technology. biology is entering a revolutionary phase building
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on the achievements of the computer advances of the 20th-century, and we are beginning to understand in a serious way the parts and circuits of living organisms, how living organisms organize, build, and manage themselves. we have a capacity now to really take on the task of being able to recognize disease as it comes, as it first appears and also to be able to generate the diagnostics, the drugs, the vaccines we need when we need them, rationally designed vaccines, manufacture them at scale and distribute them where they need to be. we should take that on as a national security priority. it would have to be a very serious strategic undertaking. i can talk about why i think the science and technology
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is there. i think the fact we do not have that already in infectious disease is a clear market failure. infectious disease is not something being invested then. they can make a lot more money investing in pals you take every day for the rest of your life. infectious diseases, you take the antibiotics for two weeks and it's over. they don't make a lot of money off of it, so we have had a remarkable diminishment in the last decade in the farm investment and anti in factors, and we have to do something about that. and we can. i was going to say something about the response in american hospitals. let me just say two words. i think the rest of the medical system learned a lot from taxes.
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i was surprised that texas was unable to manage containment of infectious diseases. this is a big, sophisticated hospital we are talking about. i think what we learned is, we have probably been making a lot of mistakes in disease containment all along across the united states, but it was more forgiving with infectious diseases like tuberculosis and hiv. you make a mistake with ebola and the health care workers around these sick patients with high viral loads are going to get sick. i know hawkins has now trained about 500 people in this enhanced personal protective gear and procedures that we are now using. i think other major hospitals are doing the same. so we ought to be able to protect our health care workers. that is obviously an imperative here and in africa, and i think we will
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start doing that. one of the questions i had of us is, are we really going to be able to do this in a handful of hospitals designated as receiver sites, or do we need more hospitals to be able to handle this? if we do not come as charlotte said, if we do not contain this in africa, then ebola will become a fact of life, and every time you get a fever you will wonder what you've got in the days ahead . so the primary thing we have got to do is contain this in africa and understand what is at stake and how much of the burden the united states is going to have to bear to remove this threat from the planet. >> thank you. >> all right. i will moderate from up here so i can see everybody better. i have a couple of questions, but i will let you go first.
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we have microphones. pulled up your hand. we will get the microphone to you. identify yourself. within two sentences i want to hear? >> hi. my name is dave prius, retired reporter, educator. one question i have, how do you think the media has helped or hurt this? i have my own feelings. as you have all said, we cannot go back. the other is not a question, but i want to thank the panel. in a time of fear, to hear just stable facts is what we need more of, so maybe this could replace modern family or something this week on tv we could give up one or any group of things. >> anybody want to take that ? the scorecard on the press. >> i think the media serve an important role in highlighting the situations
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that without their u.s. government would not necessarily pay attention to this barometer of what is resonating out there so they have a good feel. i do not think the u.s. government should follow the media. they should be ahead of them , but unfortunately that is not always the case. is there some panic being driven by the media? shore. public outrage has been hysterical. at the same time, it has highlighted the cdc initial response was inadequate. we need to do better. i think that there is a very difficult messaging challenge that public health officials face. public health communications , what you want to do is you want to avoid panic.
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when people start storing stuff in their home and hoarding, you don't want that, but at the same time, you have to be absolutely upfront and honest about the challenges. some happy thoughts. you know, with a boa -- that is always a difficult, narrow bridge. ebola is particularly difficult to because you have it being talked about, absolutely devastating in africa. at the same time, the danger of a widespread outbreak in the u.s., i think, is remaining relatively low. that does not mean there won't be outbreaks in the u.s. i expect to see more cases, but i think we have the capacity if we do the right thing. if we do the right thing we have the capacity to control the spread of ebola in the
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u.s. it is tough from that standpoint. it gets exacerbated. >> can i -- the other problem is, we don't. so the story changes. the media presents that as they really do not know what they're doing. i was surprised that the hospital in texas did not do the right thing, and i think that was because we did not know enough about how to protect health care workers against ebola, in part. now we are learning, changing regulations, to take one little point. that is seen as or presented by some media as the cdc does not know what it is doing. we have to recognize, especially now when we have much more powerful means of
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learning as we go, we are going to amend our original views as we learn more, and people have to expect that. i also think some of the best pieces in the media, particularly the written media. but, you know, there is an emotional strain that people find addictive. you know, it is not always helpful. >> quickly, and nerve that is struck. a representative, some things are really good and some things are really bad, trying to draft people's popular perception which becomes a friend of reference. in some ways, it does not take much to really kind of stimulation that fear in the public's mind. >> next question.
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right there. >> hello. so, we are seeing fda regulations, a barrier to some diseases, new tests, new drugs, do you think that kind of stuff, better access in a timely fashion? >> i think the fda is doing the right thing. i think the real question is , why the heck do we not have any bow of vaccine right now? why did that not get through trials before now? we ought to go back and really look at nih. those are working very hard now. we need to figure out why it was we had more than half a dozen ebola therapy --
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therapeutics and vaccines in the pipeline. we did not get any of them through. bob personally worked very hard on those programs when originally conceived and set up. they do not resemble those original ideas in their current incarnation. i am with the fda on this one. i have a former colleague who was taking care of patients in africa who got an kneele stake. as you can imagine, everyone was very worried. he took one of the new therapeutics and got really, really help. and you see that a lot in anti in fact tense. you are trying to tweak the immune system, trying to trick the immune system into mastering its defenses against this budget, and the case of ebola, it's hold modus operandi is to turn off the immune system and sneak around into the organs
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. and you turn the immune system on in the wrong way and you can kill people. so we have to do safety trials. it is crazy to think about giving out, i think, vaccines or therapeutics, particularly therapeutics without safety trials. we do have test do this efficiently and effectively. but you do not want to just go giving people something untested. it could really backfire and cost you the confidence of the public without which you cannot contain this disease. >> i will build on that a little bit. you cannot just say it is the fault of the fda we don't have these therapeutics. the question is -- and i certainly think that you cannot go without safety
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trials. the question is, does fda changed its practices to some degree in recognizing what is a mortal threat? and very high mortality rate. you have seen what i call the pendulum when it comes to facing deadly diseases. for example, the late 80's and 90's when you had the hiv aids situation, a lot of protesters. but they were saying that the fda needed to loosen up some of the trials and order to allow people who were facing a death sentence to try therapeutics that they would not try if they were not facing a life or death situation. and use of the pendulum shift a little bit in that time, the mid-90s, the highest number of new approvals by the fda.
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i think those are not unrelated. this might lead to some of those kinds of shifts within the fda about how to approach this. >> in terms of mechanisms used today, compassionate use which allows the fda to make a judgment subject to data available at the time, drug or therapeutic, but i go back to what was said originally, the first principle of medicine is do no harm, and light of these materials, it is very early in the clinical phase testing. and there was the right question asked, why is it taking so long? the answer is, there are still early in clinical evaluation. the fail because they are not effective, can actually cause harm verses being a therapeutic.
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>> hello. i had a question. this is about r&d. he said there needs to be a forum with are indeed being inspected. are you seeing any of that now? what specifically do you think is happening on the ground that would have helped? >> i am not sure i understand the question. r&d related to ebola? i think there are a lot of people trying to understand the science of ebola. if you go into any of the major journals, all ebola all the time for the past several weeks. you will see them trying -- the experts are trying to gather what is known and solidify their understanding
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of what the remaining questions are and how to approach them, hence the science argument going on at who in geneva and elsewhere about how to proceed with vaccine trials, for example. so the research community will rise to the occasion, but it will do so if it does research, which is individual principal investigator by individual principal investigator. i would argue for a concerted national effort with the very purpose-driven science to figure out how to rapidly rationally design a vaccine in the face of an emergent threat and manufacture it at scale. i think we can do that. there are different avenues we can explore. some of it is a day exercise. some of it is a manufacturing exercise. i think i would organize it very differently than basic r&d is usually organized,
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and i would argue it is time not just because of a boa and not just because of epidemics threat but because of economic competitiveness, it is time for america to have a strategic approach to the biological sciences, life sciences that we have never had before. we have done it with physical sciences because we saw its importance to national defense. national defense will does start to depend upon biology in a big way, whether you are talking -- well, i will leave it at that. ..
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we have kind of a hit or miss approach to develop countermeasures whether it be for heart disease or cancer in some ways having a more rationalized issue would not only improve health but lower the cost of health and that's another part of the equation here. but there are opportunities and to quote rahm emanuel which i don't often do is the idea that don't let a crisis go to waste. in this case rather than trying to address the ebola ebola problems equal can address a larger set of issues to be able a problem to identify the things that will make a difference not only for the next epidemic for
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the next common thing that has a way of causing the significant disruption and cost. >> i would add quickly that i won't put it as starkly as tara did to generate countermeasures have essentially failed but i would say those programs can be improved and we need to do better research and many two for two better at generating new research for the challenges that we face as opposed to finding ways for farming companies to leverage their existing products into something that -- might want to have. >> the young lady right there. this one and we will get you next. >> talk radio news. you guys touched him as a little bit that i was wondering if you could give your perspective on the clinton policies that have been put in place by a few states. >> i will take a whack at that.
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i'm a new yorker. i believe that governor of new york and the governor of new jersey are doing what they think is in the best interest of the people. i think it highlights of it highlights if you will a in the armor the guidelines that cdc put out. this is not to be construed as a criticism but as a medical epidemiologist i will cite a few of the facts. besides potentially being exposed to fruit bats in africa subject to the risk of contracting ebola probably the greatest risk factor for anything or anybody is being a health care worker taking care of someone who has ebola. the issue in the current cdc guidelines is open for interpretation, the role of controlled movements or unfettered movement of better word for that, they could be used for a variety of different people. they don't necessarily highlights health care workers who have been exposed to ebola to be at higher risk.
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obviously the dallas case, it was the only risk for those two nurses that i think in the case if you look at the -- you can argue health care workers taking care of her ebola victims have the bigger risk and it's dependent on their ability to protect themselves with protective equipment. in africa today that's a well exercised effort by the number of volunteers and health care workers doing all the right things. the question is at the same in united states? you could argue in the case of dallas for people not familiar with this activity familiar with managing ebola cases, not familiar with the personal protective equipment, that may be an issue. now you can look at what's happening in new jersey right now with the nurse today who is effectively in quarantine or you could say maybe that was a
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little bit too stark of an approach. maybe the right choice would have been a staycation if you will in terms of ensuring the person remained at home and had assistance available to do so and to be able to monitor that. but i think it represents sometimes the challenges in trying to put together guidelines that are universal in their reach again cdc just makes recommendations. it's the state and local responsibility to implement them and state laws determine that. that is a research function identified in the constitution that they have the right to do that. how that gets implemented or if it gets implemented appropriately obviously will be sorted out here soon enough. it highlights some of the challenges that are out there. >> there a reason it's a challenging issue. there are important issues in conflict over this. there's obviously the
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constitutional right to free movement and you can't be incarcerated by your own government and just cause and at the same time there is the right of the public to safety and you want to encourage people to feel safe going about their daily lives so there appear to be some complex here. one thing that i was thinking thinking about with perhaps doctors without borders has a smart policy of telling doctors who serve in a series that they should not return to their hospitals for 21 days after they return and agreeing to that in advance. perhaps public health care workers should agree to not only aggressive self-monitoring but self quarantine before they go. one other issue is what dr. fauci talks about what she goes on the sunday shows us this question of will it encourage or discourage health care workers
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from volunteering to address the real problem in the larger problem in west africa and will it discourage health care workers from going to compassionately serve and trying control the spread of the virus there and obviously we don't want to discourage people. i would love to hear charlotte's views on this particular aspect. >> yeah i think dr. fauci's comments on discouraging people even with what the usaid will be doing and the effective countries are building facilities. there is no one there will be relying upon local public officials are volunteers willing to put themselves in harm's way. we are back to have 17 new facilities on line by next year and they need doctors to fill those facilities to treat victims. that's another side of it and
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looking at what other governments have done in the region. i think senegal nigeria both declared a bowl of free last week from their particular cases. they are still not out of the woods yet. they are in the neighborhood that travelers are likely to come back. in looking at the quarantine policy that nigerians put in place later on an existing polio outbreak protocol but if you have been directly exposed to an individual and you are put into a particular facility but didn't have officials to visit everyday knowing that new york has altered their system but i think there are lessons to be learned to successfully contain an outbreak that the original liberian diplomat in nigeria had contact with 900 individuals in the system. looking at the successes of that model thing that it does work to
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act quickly and efficiently but we have been successful. >> i think that point deserves emphasis. and posing quarantine 24 hours is irresponsible. it's a big deal to do this and it's not going to be -- we are going to have cases come into the united states through all kinds of airports. you have to be able to explain why you are quarantining somebody who has no symptoms of ebola because there's no scientific evidence that person represents a public safety threat and you have to make sure that person can get something, what was it a granola bar that the nurse had over 12 hours? which of us could actually stay in our homes for 21 days without some kind of outside support? i would run out of cornflakes in about three days.
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so if you are going to quarantine people for a good reason you have to be able to explain that reason because again the confidence of the public future key tool in controlling disease. you have to be able to actually effectively implement and that is really hard in modern societies. it is really challenging and i think doing it cavalierly kind of blows both points. it makes you seem uninformed as a leader and it also diminishes the public's capacity and competence in effectiveness. i think this was a mistake. we will amend it and recover from it and again you always learning epidemics. >> okay, the young lady in the middle. >> hi jackie. there has been numerous calls for a travel ban to ebola
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countries. what do you think the effect of this would be? >> in the bush administration we look at this question of travel ban and we need to look at the pros and cons. we only want to do something this significant when the advantages outweigh the costs. you have to think about what those costs are. the costs are discouraging travel for health care workers, making it harder to get resources there and you also have the issues of you don't know how governments will react to the u.s. or any other country shutting off travel from that nation. for example when we were dealing with the flu situations one thing we were worried about was continued cooperation of the indonesian government which didn't always want to share flu symptoms with us. liberia and guinea are tiny countries that you can't necessarily predict how another state after will react.
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you always assume there's going to be what we consider to be rational responses and some can react very strongly to this which is really an assault on the ability to maintain a viable economic system. i am loath to impose a complete travel ban. i also think that i'm not sure travel ban depending on how you figure it but liberians for example can't come to united states that would necessarily stop a situation like dr. spencer who is a u.s. citizen with a passport who would come into the country. you have to think about carefully how you do it and be reluctant to do a blanket travel ban in the situation. >> i do think that there are some lessons to be learned from senegal and nigeria. senegal shares a 30-kilometer border with liberia so their position is a bit different than
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nigeria that did not implement any travel bans. there was was a 48-hour. not that they were monitoring checkpoints but after that point they did reopen all links and senegal does share a direct border with that country did close down their border checkpoints. even shipping coming into the country was also canceled until the ebola, until they were declared a bowl of free and they have reopened at this point. seeing that in nigeria is economically connected in a part of this hub but it is a couple of steps removed from the affected country so kind of thinking along those lines ethiopia is another one that has travel links to the region. they have put in some strict temperature measures. when you enter the country from
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one of those places but again i kept links open and even looking at considerations of the travel ban and most of us know at this point there are no direct flights to the united states. then that starts getting into what do we do with their european friends and middle eastern friends whose emirates flies several flights into the region. so it mushrooms out faster and i think people realize what it sounds like a core fix. >> i want to exercise my moderators prerogative and oust the last question, the same question for all four of you. you have been named the ebola czar and i have to tell you there are a couple of people standing in front of you there would have been good candidates for the ebola czar based on their experience and knowledge. what is the one thing that you would put into place today?
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whoever is ready can go first. nobody is ready. [laughter] >> medical workers who get sick in africa to advance medical care. >> the first thing i would do would be an attempt to refuse. william f. buckley was asked in 1970 -- 1965 the first thing he said to do would be to demand a recount. obviously i think the number one thing you have to do is from the perspective of that position is to get a better handle on the capabilities and better cooperation within the various violet pieces of the u.s. government to make sure they are working in concert. >> i think leveraging private
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sector both in the u.s. and the region there have been some efforts and there's a u.n. committee working to do that. i think there is plenty of private sector organizations in these countries american or library and sierra leone that have a lot of resources and have the ability to actually change what's going on on the ground. >> i'm going to cheat a little bit because i think there are three things that have to be done. first of all i think it's been highlighted logistics piece of this and how it can effectively protect the power of the united states to do what i can across the region. the second thing is i particularly believe that there has got to be a means to basically fill those ebola treatment facilities and me to think creatively about that. we have really been relying on faith-based organizations and nongovernmental organizations. i would highlight what the
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germans did where are health care workers basically went on paid leave to basically go and help respond to the ebola crisis. there entities in the united states that could do something similar on that and the third thing is the one thing the united states has is to provide and accelerate winding safe and effective leaders which we have certainly early in development and could be deployed fairly quickly if they go through the kind of necessary if you will clinical trials domestically before we apply them internationally. >> folks i don't know about you but this has been one of the most reasonable fact-based bodies i have seen discussed weather was on tv, on the radio or in print. it's a treat to talk with professionals about things that
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their knowledge informs rather than just on emotions. i would ask you to join me in thanking the panel. [applause] school for national
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studies. >> good morning ladies and gentlemen. i am bothered visiting scholar
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on site working with spikes to develop a program in agriculture and food security teaching a couple of courses in that area. i am delighted and are continuing seminar and international agricultural topics that today we have former secretary of agriculture dan glickman here to talk about food security and government dysfunction, progress be made in the current environment? dan is the executive director of the aspen institute's congressional program, nongovernmental, nonpartisan educational program for members of the united states congress. he is also senior fellow at the bipartisan policy center which promotes bipartisanship in addressing the key challenges that confront the united states. he co-chairs the commission on political reform, democracy project nutrition and physical activity initiative and the task force on defense budget and
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strategy. secretary glickman was secretary of agriculture from 1995 to 20 2001. before that he represented kansas historic district in united states house of representatives for 18 years. during that time he served in the ag committee. he was the chairman of the subcommittee responsible for programs for six years. he also was an active member of the house judiciary committee and served as chairman of the house permanent select committee on intelligence. two other interesting features he served as chairman of the motion picture -- from 2,042,010 and director of the institute of politics at harvard's kennedy school from 2002 to 2004. dan we are delighted to be here today and welcome to the podium. [applause]
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>> thank you bob and i am most appreciative. bob thompson is my hero. if you asked me the smartest person in the world but person i thought was the smartest world on agriculture policy with the managers introduce me. he was ahead of agriculture at world bank and usda when i was a congressman and i think he still likes me even though it was during the reagan years and the most friendly during that period of time. i am delighted to be here. listing to my biography it sounds like i can't keep the job. you know the frank sinatra song i've been a poet of poverty cane of poverty cane. i've been 19 different things in my life but my interest in food and farm issues and related
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global agriculture issues and my interest in the u.s. congress and how it operates and our government ties these issues together. but i don't think -- there are a lot of experts in agricultural. we have an election coming if you haven't noticed if you watch tv all the time. you can't turn off these advertisements run by candidates for office but i think you have to look at our political system and how it functions. i'm going to talk mostly about the u.s. political system today. i know there are people from overseas here. i think it has a lot to do what food in our culture and global policies are all about. you have to understand the politics of this country specifically and also the politics of agriculture and food to get a picture of what can we
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do and what should we do and what could the united states be doing as we do with the security issues and how we impact the rest of the world. i think one general theme is agricultural interests are very powerful. here in the u.s. and in most countries. they are disproportionately more powerful to the numbers of people who are in the field. if you look at today united states anywhere between one and a a quarter and one-3/4% of the people are producing food in terms of the larger number of people who are in the business generally. then you look at u.s. policy as it's related to farm programs and related issues. you really see that there is historically a much greater power and interest in agriculture than they are are in the numbers people in this


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